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Too high especially at night

L

liverdie

Member
Messages
11
Type of diabetes
Carer
My type 1 daughter aged 9 always seems to get high sugar at night. We also suffer with hypos during day. I use librefreestyle and we see overnight it is always 200 plus.
Am I right in thinking to move to a low carb diet for her as we can't get the levels right?
 
It may help, but adjusting basals/bolus and analysing food effects would be probably better.

I assume it climbs during the night from what you are describing, and not dipping and then rising?

Is she on pump or MDI?
 
Hi @liverdie. As donnellydogs has said you may need to re assess your daughter's basal/bolus regime.
Going hypo in the daytime is equally as bad as going high overnight.
You maybe over treating daytime lows which from personal experience can lead to high sugars for quite a few hours later.
I'm sure you'll find a solution, as with a lot of things diabetes related it's trial and error.
Good luck.
 
liverdie said:
My type 1 daughter aged 9 always seems to get high sugar at night. We also suffer with hypos during day. I use librefreestyle and we see overnight it is always 200 plus.
Am I right in thinking to move to a low carb diet for her as we can't get the levels right?
Click to expand...

What basal insulin does she use and when does she take it?

Persistent highs or lows are usually due to insulin issues not food (unless she's eating a vast amount of carbs).
 
Hi. On regular injections
donnellysdogs said:
It may help, but adjusting basals/bolus and analysing food effects would be probably better.

I assume it climbs during the night from what you are describing, and not dipping and then rising?

Is she on pump or MDI?
Click to expand...
Not on pump.
It does climb at night yes, not dipping. You suggesting increase basal?
 
therower said:
Hi @liverdie. As donnellydogs has said you may need to re assess your daughter's basal/bolus regime.
Going hypo in the daytime is equally as bad as going high overnight.
You maybe over treating daytime lows which from personal experience can lead to high sugars for quite a few hours later.
I'm sure you'll find a solution, as with a lot of things diabetes related it's trial and error.
Good luck.
Click to expand...

Does seem like we may be giving too high dose in day time I think
 
azure said:
What basal insulin does she use and when does she take it?

Persistent highs or lows are usually due to insulin issues not food (unless she's eating a vast amount of carbs).
Click to expand...
Basal dose is 12 taken at night about 1 hour before sleeping
 
Any idea from anyone about the idea of going for low carb options like paleo? Not sure if good idea for 9 year old
 
Is it lantus or levemir?

We aren't allowed to officially give advice as none of us are professionals, HOWEVER, we can suggest what we would do in your scenario.

First off it would help if we had a days worth of levels, units insulin etc.

Ie
3am bg test. 5.0. No insulin

8am bg test 13.0
1 unit correction
32g cereal
3 units bolus

10am bg test 3.6

1pm Lunch
Bg level 7.4
25g jacket spud with salad
No correction
2.5 bolus


Etc, etc...

It would enable us to give you guidance as to the changes we would make if it was us.

Personally from
just my opinion give good, homemade foods where possible from as much fresh nutients and foods as possible.
The only thing I would restrict would be heavy laden things like processed foods, takeaways etc.
For me its hard to balance the idea of restricting any nutritional categories from a childs diet ie going veggie, or paleo unless there is a medical need for it. I don't for myself count T1 as a need to restrict to certain food groups. I don't really agree with the NHS stance of 230g carbs for children, as I think this is too high. Again just my own personal views... Others will come along with different thoughts.

Have you got 1/2 unit pens?

Have you read books like "think like a pancreas" etc?

What guidance are you getting from the hospital?
 
liverdie said:
Basal dose is 12 taken at night about 1 hour before sleeping
Click to expand...

What kind of insuljn does she take? If she's going high at night, her basal insulin dose and timing needs looking at. It might need increasing or it might need the injection earlier or it might need splitting into two doses - or even a combination of those things.

There shouldn't be any need to change her diet.

The problems you've described suggest her imsulin needs adjusting in some way. If this is a fairly sudden change, it could be that she's going through a growth spurt. It may take a little experimenting with her insulin (with the help of her team) but you should be able to sort this :)
 
azure said:
What kind of insuljn does she take? If she's going high at night, her basal insulin dose and timing needs looking at. It might need increasing or it might need the injection earlier or it might need splitting into two doses - or even a combination of those things.

There shouldn't be any need to change her diet.

The problems you've described suggest her imsulin needs adjusting in some way. If this is a fairly sudden change, it could be that she's going through a growth spurt. It may take a little experimenting with her insulin (with the help of her team) but you should be able to sort this :)
Click to expand...
It was 6.7 before sleeping and now in morning it's 10.9. She takes 12 Lanctus at around 1 hour before sleeping
 
mahola said:
If you get her basal/bolus doses correct, there is no need to go low carb. If she's going hyper at night after suffering hypos in the day, you could possibly be over treating the hypos.

What time of day is she having the hypos; before/after breakfast, before/after lunch?
Click to expand...
Normally before food we give the novorapid. Then it seems to go low after about 2 hours but only sometimes. No fixed time. Maybe need to reduce novorapid
 
donnellysdogs said:
Is it lantus or levemir?

We aren't allowed to officially give advice as none of us are professionals, HOWEVER, we can suggest what we would do in your scenario.

First off it would help if we had a days worth of levels, units insulin etc.

Ie
3am bg test. 5.0. No insulin

8am bg test 13.0
1 unit correction
32g cereal
3 units bolus

10am bg test 3.6

1pm Lunch
Bg level 7.4
25g jacket spud with salad
No correction
2.5 bolus


Etc, etc...

It would enable us to give you guidance as to the changes we would make if it was us.

Personally from
just my opinion give good, homemade foods where possible from as much fresh nutients and foods as possible.
The only thing I would restrict would be heavy laden things like processed foods, takeaways etc.
For me its hard to balance the idea of restricting any nutritional categories from a childs diet ie going veggie, or paleo unless there is a medical need for it. I don't for myself count T1 as a need to restrict to certain food groups. I don't really agree with the NHS stance of 230g carbs for children, as I think this is too high. Again just my own personal views... Others will come along with different thoughts.

Have you got 1/2 unit pens?

Have you read books like "think like a pancreas" etc?

What guidance are you getting from the hospital?
Click to expand...
We are in qatar. Very little guidance appointment every 2 months and they seem to want us to aim higher with scores like 150 fasting. We just started carb counting this week. Using the librefreestyle is giving more info but I think highlighting more hypers.
 
The carb counting will help enormously. With help, you should be able to find the right amount of Novorapid for each meal. When I was first diagnosed, I kept records. I sometimes ate the same food a few days in a row to help me get the mealtime insulin right.

The first thing to try to get right is the Lsntus. The basal insulin is the foundation you build on. If you get that right, it's easier to get the mealtime doses right.

I don't use !antus as I have a pump. I'm going to tag @noblehead as I think he's used it in the past. Im wondering whether a change of time for that injection might help. You could ask.
 
liverdie said:
Basal dose is 12 taken at night about 1 hour before sleeping
Click to expand...

You can take lantus anytime of day as long as you leave a 24 gap between injections, I used to inject my lantus just before bed then moved it to earlier in the evening around 6pm.

I did this after speaking with my DSN and I would suggest you speak with your daughters diabetes team first if you decide to move the basal dose.
 
Also, glad you now carb counting.

If going low 2-3 hours after a bolus injection, it is because the bolus was too much. Have you got a meter like the aviva expert that allows you to enter your carb ratios and correction ratios to calculate your doses to give?

If you are working on the same bolus ratio for breakfast, lunch, dinner, it may be that they need tweaking. I have 6 different time slots and ratios that take into account that I'm busier in mornings than afternoons etc..
 
noblehead said:
You can take lantus anytime of day as long as you leave a 24 gap between injections, I used to inject my lantus just before bed then moved it to earlier in the evening around 6pm.

I did this after speaking with my DSN and I would suggest you speak with your daughters diabetes team first if you decide to move the basal dose.
Click to expand...
Why did you move your lantus to earlier and how did it help?
 
Kristin251 said:
Why did you move your lantus to earlier and how did it help?
Click to expand...

At the time I was having a few issues with hypo's during the night despite decreasing the basal dose, I/we figured that if I took it earlier in the evening any issues could be solved before bed rather than waking up low in the middle of the night, as it happens it did help strangely enough and the night-time hypo's were greatly reduced.
 
I used to take mine with dinner and it lowered my bs a lot but think it got all used up on food so moved it to 10pm and I stay flatter. For some reason lately I needed to bump it up a unit. BF still stinks. I get my spike around 2.5-3 hours after I eat so I take a correction then but j wish I could avoid that.
 
Really can't work it out. Daughter blood sugar was 16 at night about 10 pm. I have 4 novorapid for correction. 30 later it was 18. I have another 2 novorapid. Checked at 4am and it is 16. Prior to this gave basal at about 5pm of 16 units.
Confused as it is high all night. I know a bit of the dawn phenomenon but would still expect novorapid to have some impact.
Any help?
 
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